Open-label Study of ELA026 in Participants With Secondary Hemophagocytic Lymphohistiocytosis (sHLH)

Last updated: August 4, 2025
Sponsor: Electra Therapeutics Inc.
Overall Status: Active - Recruiting

Phase

2/3

Condition

Neoplasm Metastasis

Treatment

ELA026

Clinical Study ID

NCT05416307
ELA026-CP002
  • Ages > 6
  • All Genders

Study Summary

Hemophagocytic lymphohistiocytosis is a rare, aggressive and life-threatening syndrome of excessive immune activation. Secondary hemophagocytic lymphohistiocytosis (sHLH) is the most common form of this disease and is typically associated with several other clinical conditions (eg, malignancy associated HLH (mHLH), infection, or autoimmune disease). ELA026 is a fully human immunoglobulin G1 (IgG1) signal regulatory protein (SIRP)-directed monoclonal antibody designed to deplete the myeloid and T cells driving the inflammation. The purpose of this study is to assess the safety, efficacy pharmacokinetics and pharmacodynamics of ELA026 in participants with sHLH.

Eligibility Criteria

Inclusion

Key Inclusion Criteria for Part 1:

  1. ≥12 years at the time of HLH diagnosis (Cohort 1).

  2. ≥6 years at the time of HLH diagnosis (Cohort 2-3).

  3. Treatment naïve or relapsed/refractory (Cohorts 1 and 2).

  4. Treatment naïve or early refractory (Cohort 3).

  5. Participant with sHLH confirmed criteria based on fulfilling 5 out of 8 HLH-2004 diagnostic criteria.

Key Inclusion Criteria for Part 2:

  1. ≥18 years old, with treatment-naïve mHLH, diagnosed by HLH-2004 criteria, triggered by any type of malignancy (Cohort A).

  2. ≥18 years old ≥12 to 17 years old with treatment-naïve sHLH, diagnosed by HLH-2004 criteria, not triggered by any type of malignancy (Cohort B).

  3. ≥18 years old, with treatment-naïve mHLH, diagnosed by biomarker criteria but not meeting HLH-2004 criteria, triggered by any type of malignancy (Cohort B).

  4. 13 to 17 years old with treatment-naïve sHLH, diagnosed by HLH-2004 criteria, due to any trigger (Cohort B).

  5. 6 to 12 year old, with refractory sHLH, diagnosed by HLH-2004 criteria due to any trigger (refractory defined as ≤ 2 weeks of HLH-directed therapy with suboptimal response as determined by the investigator - safety lead-in cohort).

  6. 6 to 12 year old treatment-naïve sHLH diagnosed by HLH-2004 criteria due to any trigger.

Key Exclusion Criteria for Part 1:

  1. Known or previous treatment for primary HLH

  2. Any other significant concurrent, uncontrolled medical condition that in the opinion of the Investigator contraindicates participation in this study

  3. Unknown trigger for sHLH

  4. Active, relapsed/refractory malignancy for which no suitable therapies are available to treat the malignancy triggering the HLH

  5. Allogeneic hemopoietic stem cell transplant (HSCT) within 100 days of the first dose of ELA026.

  6. Ongoing administration of any therapies used to treat HLH (excluding dexamethasone)

  7. Live or attenuated vaccine received within 6 weeks or bacille Calmette-Guerin (BCG) vaccine within 12 weeks prior to Screening

Key Exclusion Criteria for Part 2:

  1. Refractory sHLH (except for the safety lead-in cohort for 6-12 year old in Cohort B).

  2. Known or suspected primary or hereditary HLH.

  3. Severe organ dysfunction.

  4. Any other significant concurrent, uncontrolled medical condition that contraindicates participation in this study or prohibits completion of study procedures.

  5. End-stage malignancy for which no suitable therapies are available to treat the malignancy triggering the HLH.

  6. Allogeneic hemopoietic stem cell transplant within 100 days prior to the first dose of ELA026 or within 30 days of study enrollment.

Study Design

Total Participants: 156
Treatment Group(s): 1
Primary Treatment: ELA026
Phase: 2/3
Study Start date:
May 19, 2022
Estimated Completion Date:
June 30, 2029

Study Description

This study consists of two parts: Phase 1b (Part 1) and Phase 2/3 (Part 2).

Part 1 is designed to evaluate the safety, efficacy, pharmacodynamics, and pharmacokinetics of ELA026 in pediatric and adult participants with treatment-naïve (TN) and relapsed/refractory sHLH. The main objectives of Part 1 are to determine the safety of ELA026 administered intravenously (IV) and subcutaneously (SC) to participants with sHLH and to identify the recommended Phase 3 dose and schedule for ELA026. Participants will be enrolled into a dose-escalating cohort (Cohort 1) followed by two fixed dose cohorts (Cohorts 2-3) treated over 12-weeks.

Part 2 (SURPASS) is designed as an open-label, single-arm, multicenter, historical control registrational study to evaluate ELA026 in TN adult and pediatric sHLH participants. All participants are diagnosed with HLH-2004 criteria unless indicated. Cohort A (primary cohort) will enroll TN participants ≥18 years old with mHLH. Cohort B (exploratory cohort) will enroll participants including ≥18 years old participants with TN sHLH not triggered by malignancy; ≥18 years old participants with TN mHLH diagnosed by biomarker criteria but not meeting HLH-2004 diagnostic criteria; and 6 to 17 year old participants with TN sHLH (due to any trigger). For 6 to 12 year old participants, there is a safety lead-in cohort with refractory sHLH.

Part 1 is closed to recruitment and Part 2 is recruiting for eligible participants.

Connect with a study center

  • Medizinische Universität Innsbruck

    Innsbruck,
    Austria

    Site Not Available

  • Medical University of Vienna

    Vienna,
    Austria

    Completed

  • Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico

    Milan,
    Italy

    Completed

  • Bambino Gesu' Roma

    Roma,
    Italy

    Site Not Available

  • Amsterdam UMC

    Amsterdam,
    Netherlands

    Site Not Available

  • Erasmus UMC

    Rotterdam,
    Netherlands

    Site Not Available

  • Hospital 12 de Octubre, Madrid

    Madrid,
    Spain

    Site Not Available

  • Hospital Ramon y Cajal

    Madrid,
    Spain

    Completed

  • Hospital La Fe Valencia

    Valencia,
    Spain

    Site Not Available

  • University College London Hospitals

    London,
    United Kingdom

    Site Not Available

  • University of Alabama

    Birmingham, Alabama 35294
    United States

    Site Not Available

  • University of Alabama at Birmingham School of Medicine

    Birmingham, Alabama 35233
    United States

    Active - Recruiting

  • Phoenix Children's Hospital

    Phoenix, Arizona 85016
    United States

    Site Not Available

  • University of California, Los Angeles

    Los Angeles, California 90095
    United States

    Site Not Available

  • MedStar Georgetown

    Washington, District of Columbia 20007
    United States

    Site Not Available

  • Johns Hopkins All Children's Hospital

    St. Petersburg, Florida 33701
    United States

    Active - Recruiting

  • Moffit Cancer Center

    Tampa, Florida 33612
    United States

    Site Not Available

  • Columbia University

    New York, New York 10032
    United States

    Active - Recruiting

  • Memorial Sloan Kettering Cancer Center

    New York, New York 10065
    United States

    Site Not Available

  • Thomas Jefferson University

    Philadelphia, Pennsylvania 19107
    United States

    Active - Recruiting

  • MD Anderson

    Houston, Texas 77030
    United States

    Site Not Available

  • Texas Children's Hospital

    Houston, Texas 77030
    United States

    Active - Recruiting

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